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意大利认知障碍和痴呆中心在阿尔茨海默病新药背景下的概况。

The Profile of the Italian Centers for Cognitive Disorders and Dementia in the Context of New Drugs in Alzheimer's Disease.

机构信息

Department of Human and Social Sciences, University of Salento, Lecce, Italy.

National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy.

出版信息

J Alzheimers Dis. 2024;101(2):509-524. doi: 10.3233/JAD-240594.

Abstract

BACKGROUND

The wait for the upcoming disease-modifying therapies (DMT) for Alzheimer's disease in Europe is raising questions about the preparedness of national healthcare systems to conduct accurate diagnoses and effective prescriptions. In this article, we focus on the current situation in Italy.

OBJECTIVE

The primary goal is to propose a profile of the Italian Centers for Cognitive Disorders and Dementias (CCDDs) that could be taken into consideration by regional and autonomous provincial authorities when deciding on the prescribing centers for DMT.

METHODS

Based on responses to a national survey on CCDDs in Italy, we identified the CCDDs that meet the requirements for effective prescription: 1) Multidisciplinary team; 2) Minimum Core Test for the neuropsychological assessment; 3) PET, CSF, and Brain MRI assessments. Univariate and multivariate comparisons were conducted between CCDDs that met the criteria and the others.

RESULTS

Only 10.4% of CCDDs met the requirements for effective DMT prescription, mainly located in Northern Italy. They are also characterized by longer opening hours, a higher number of professionals, a university location, and a higher frequency of conducting genetic tests, and could potentially result in prescribing centers.

CONCLUSIONS

The findings suggest that the Italian national healthcare system may benefit from further enhancements to facilitate the effective prescription of DMTs. This could involve initiatives to reduce fragmentation, ensure adequate resources and equipment, and secure sufficient funding to support this aspect of healthcare delivery.

摘要

背景

欧洲即将推出的阿尔茨海默病治疗药物(DMT)引发了人们对各国医疗保健系统是否准备好进行准确诊断和有效处方的质疑。本文重点关注意大利的现状。

目的

主要目标是为意大利认知障碍和痴呆症中心(CCDD)提出一个概况,为地区和自治省当局在决定 DMT 处方中心时提供参考。

方法

基于对意大利 CCDD 的全国性调查的回应,我们确定了符合有效处方要求的 CCDD:1)多学科团队;2)神经心理学评估的最低核心测试;3)PET、CSF 和脑 MRI 评估。对符合标准和不符合标准的 CCDD 进行了单变量和多变量比较。

结果

只有 10.4%的 CCDD 符合有效 DMT 处方的要求,主要集中在意大利北部。它们还具有更长的营业时间、更多的专业人员、位于大学所在地、以及更高频率的基因测试,有可能成为处方中心。

结论

研究结果表明,意大利国家医疗保健系统可能需要进一步加强,以促进 DMT 的有效处方。这可能涉及减少碎片化、确保充足的资源和设备、以及确保足够的资金来支持这一医疗保健提供方面的举措。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a88e/11492016/c096a30a0e84/jad-101-jad240594-g001.jpg

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